Prise en charge de l’anaphylaxie en médecine d’urgence. Recommandations de la Société française de médecine d’urgence (SFMU) en partenariat avec ... View Full Text


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Article Info

DATE

2016-09

AUTHORS

A. Gloaguen, E. Cesareo, J. Vaux, G. Valdenaire, O. Ganansia, S. Renolleau, G. Pouessel, E. Beaudouin, H. Lefort, C. Meininger, les membres de la commission des référentiels de la SFMU, et experts de la SFA, du GFRUP et de la SP2A

ABSTRACT

Ces recommandations formalisées d’experts ont été élaborées par la Société française de médecine d’urgence, avec la collaboration de la Société française d’allergologie, le Groupe francophone de réanimation et urgences pédiatriques, et le soutien de la Société pédiatrique de pneumologie et d’allergologie. Leur but est de sensibiliser les urgentistes au diagnostic précoce de cette réaction d’hypersensibilité sévère potentiellement fatale, aux particularités liées à l’âge et à l’identification de ses facteurs de risque. Le diagnostic d’anaphylaxie est clinique et repose sur l’utilisation des critères cliniques de Sampson. Les auteurs proposent des fiches d’aide à la régulation médicale ainsi que des critères de tri pour les infirmières organisatrices de l’accueil. Comme le soulignent les recommandations internationales, le traitement principal repose sur l’administration précoce d’adrénaline par voie intramusculaire. En présence d’un auto-injecteur d’adrénaline (AIA), le médecin régulateur du service d’aide médical urgente (Centre 15) doit favoriser son utilisation sans attendre l’arrivée des secours. Puis en fonction du contexte, le traitement repose sur l’éviction du facteur déclenchant, une position d’attente adaptée, une oxygénothérapie et, en fonction des symptômes, un remplissage intraveineux, des aérosols de bronchodilatateur ou d’adrénaline. La gravité du pronostic et le caractère imprévisible de l’évolution justifient l’engagement d’une unité mobile hospitalière. Une surveillance minimale de six heures est indiquée en structure hospitalière. Le dosage de la cinétique de la tryptase contribue au diagnostic, a posteriori. À la sortie de l’hôpital, le patient doit avoir une prescription de trousse d’urgence (comportant au minimum deux AIA et des β2-mimétiques), des consignes écrites et un compte rendu écrit détaillé. Une orientation vers une consultation allergologique est indispensable. More... »

PAGES

342-364

References to SciGraph publications

  • 2015-12. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines in WORLD ALLERGY ORGANIZATION JOURNAL
  • 2014-03. Human heart as a shock organ in anaphylaxis in ALLERGO JOURNAL INTERNATIONAL
  • 2011-12. World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis in WORLD ALLERGY ORGANIZATION JOURNAL
  • 2014-12. International consensus on (ICON) anaphylaxis in WORLD ALLERGY ORGANIZATION JOURNAL
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s13341-016-0668-2

    DOI

    http://dx.doi.org/10.1007/s13341-016-0668-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1050141389


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